Characteristics and Costs of Impaired Fasting Glucose

描述（由申请人提供）：糖尿病预防计划（DPP）的最新发现已经确定糖尿病是可以预防的，或至少可以延迟。DPP参与者的空腹血糖（FPG）水平均在95至125 mg/dl之间，低于目前诊断糖尿病的阈值。美国糖尿病协会认为在正常葡萄糖水平（FPG <110 mg/dl）和足以定义糖尿病的水平（>126 mg/dl）之间存在中间代谢阶段。 这个中间阶段，称为空腹血糖受损（IFG），是未来糖尿病的主要危险因素。正常FPG的上限（95-109 mg/dl）可能代表异常FPG的更早期阶段。 在DPP之后，我们可以期待健康计划和临床医生增加延迟或预防糖尿病的努力。 然而，IFG患者和FPG正常高值患者的特征尚未描述。特别是，我们对谁最终患上糖尿病以及如何快速发展知之甚少。此外，这些人的医疗利用和费用，相对于血糖正常的人，还没有列举。如果没有对血糖异常患者的成本进行准确的估计，预测糖尿病预防的成本节约将是不准确的。 这项研究的目的是探索中间代谢阶段（IFG）和高正常FPG，以建立一个知识库，为预防糖尿病及其并发症的策略做出贡献。 我们建议建立一个高正常FPG（95-109 mg/dl）或IFG（110-125 mg/dl）患者的注册表，并建立一个年龄和性别匹配的FPG正常（<95 mg/dl）受试者的对照组。然后，我们将描述FPG阶段的进展，从正常到高正常到受损到糖尿病，并估计多变量模型以确定这些阶段进展的独立风险因素。最后，我们将计算和比较每个FPG阶段患者的医疗费用，并估计多变量模型以确定每个阶段导致医疗费用的因素。

DESCRIPTION (provided by applicant): Recent findings from the Diabetes Prevention Program (DPP) have established that diabetes can be prevented, or at least delayed. Participants in the DPP all had fasting plasma glucose (FPG) levels between 95 and 125 mg/dl, below the current threshold for the diagnosis of diabetes. The American Diabetes Association recognizes an intermediate metabolic stage between normal glucose levels (FPG <110 mg/dl) and levels sufficient to define diabetes (>126 mg/dl). This intermediate stage, known as impaired fasting glucose (IFG), is a major risk factor for future diabetes. The upper range of normal FPG (95-109 mg/dl) may represent a still earlier stage of abnormal glycemia. Following the DPP, we can expect health plans and clinicians to increase efforts to delay or prevent diabetes. However, the characteristics of patients with IFG, and with high-normal FPG have not been described. In particular, we know relatively little about who ultimately develops diabetes and how quickly. Additionally, medical utilization and costs of these persons, relative to normoglycemic persons, have not been enumerated. Forecasts of cost savings of diabetes prevention will be inaccurate without accurate estimates of costs of patients with abnormal glucose. The objective of the proposed research is to explore the intermediate metabolic stage known as IFG, and also high-normal FPG, to build a knowledge base that will contribute to strategies to prevent diabetes and its complications. We propose to create a registry of patients with high-normal FPG (95-109 mg/dl) or with IFG (110-125 mg/dl), and also create an age- and gender-matched comparison group of subjects with normal FPG (<95 mg/dl). We will then describe the progression of stages of FPG, from normal to high-normal to impaired to diabetic, and estimate multivariate models to identify independent risk factors for progression across these stages. Finally, we will calculate and compare the costs of medical care for patients in each FPG stage, and estimate multivariate models to identify factors that contribute to medical costs in each stage.